| Research Abstract |
The chronic fatigue syndrome is a condition of unknown etiology, characterized by a persistent debilitating fatigue, the muscle-related symptoms and the neuropsychiatric symptoms. The abnormalities which explain these symptoms are currently not clear. Herein, we show that most of the patients with CFS had a serum acylcarnitine(AC) deficiency. Seventy-three patients with CFS(35 males and 38 females) and 308 normal volunteers(177 males and 131 females) were studied of free carnitine(FC) and AC concentration in serum. The AC in serum was markedly decreased in both male and female CFS patients (9.5(〕SY.+-.〔)3.4mumol/L in male patients, 9.0(〕SY.+-.〔)3.8mumol/L in female patients) than in normal controls (13.4(〕SY.+-.〔)4.6mumol/L in male controls, 15.5(〕SY.+-.〔)4.4mumol/L in female controls)(P<0.01). Furthermore, the AC was lower in the serious condition than in slight one of CFS patients, and tended to increase to the normal level with the recovery of general fatigue. In contrast to AC, mos
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t of FC in the patients with CFS were normal, and have no relationship in the degree of performance status(PS). The AC was not decreased in the bed rest patients who had a bone fracture. This means AC concentration in serum does not decrease only by the loss of daily activities. When we studied the correlation of AC deficiency with symptoms described in CDC criteria in CFS patients, there were some correlation between the AC deficiency and the degree of PS, postexertional malaise and low grade fever. The amount of AC discharged to the urine in the patients with CFS was not increased.
Furthermore, persisting endotoxemia defined with limulus lysate test was found in some patients with CFS.To clarify the relationship between this endotoxemia and fatigue, the endotoxin defined by limulus lysate test, endospecy test and toxicolor test were studied in the serum samples of patients with CFS.We found that endotoxemia defined by LLT is more frequent than those by endospecy test in patients with CFS as far as we examined. The discrepancy between the positivity of LLT and negativity of endospecy test suggest the existence of a G-factor sitimulating substance in patients with CFS.
Our current hypothesis is whatever the triggers--the stress, virus infections or unknown factors--might cause the energy metabolic dysfunctions including the abnormal carnitine metabolism, resulting in general fatigue, myalgia, muscle weakness, postexertional malaise and the neuropsychiatric symptoms in the patients with CFS. Less
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